在心力衰竭风险的门诊患者中进行高LVEDP和健康状况的非侵入性查
Omar Cantu-Martinez1, Andrew A Girard1, Weiwei Jin2
1University of Missouri-Kansas City's Healthcare Institute for Innovations in Quality, Kansas City, Missouri, USA; Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA.
JACC. Advances
|July 19, 2025
概括
近40%的风险患者显示左心室末端透缩压 (LVEDP) 升高,表明潜在的心力衰竭. 许多人经历了显著的健康状况下降,突出了早期非侵入性查的必要性.
科学领域:
- 心脏病学 心脏病学
- 主要护理医学 医疗保健
- 诊断查 诊断查 诊断查
背景情况:
- 由于非特异性症状,心力衰竭 (HF) 通常在初级保健中被诊断为晚期.
- 这导致患者出现晚期疾病,影响他们的生活质量.
研究的目的:
- 评估高风险门诊患者的非侵入性左心室末端透气压 (LVEDP) 查的诊断价值.
- 鉴定患有LVEDP升高的患者的健康状况.
主要方法:
- 使用Vivio系统查了2,040名糖尿病,慢性病 (CKD) 或疑似HF的门诊患者.
- 确定了LVEDP>18 mm Hg的患者,并使用堪萨斯城心肌病问卷总体概要 (KCCQ-OS) 评估了他们的健康状况.
主要成果:
- 在接受查的患者中,38.5%的LVEDP升高;年龄较大,女性性别和CKD是相关因素.
- 在查结果为阳性的人群中,26.5%的KCCQ-OS得分表明显著功能障碍 (NYHAII-IV类).
结论:
- 与KCCQ相结合的非侵入性LVEDP评估可以确定需要进一步评估心力衰竭的患者.
- 这种方法揭示了很大一部分高风险患者的健康状况明显恶化.
- 进一步的研究应该探索这些查策略对患者结果的临床影响.
相关概念视频
Imaging Studies for Cardiovascular System I:Echocardiography
492
Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
492
Heart Failure VII: Nursing Interventions
140
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
140
Heart Failure IV: Classification and Diagnostic Evaluation
33
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
33
Imaging Studies for Cardiovascular System II:Types of Echocardiography
396
Echocardiography plays a role in assessing cardiac health and detecting heart conditions, with various types providing critical insights for diagnosis and treatment.
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
396
Exercise Stress Test
506
Introduction
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
506
Heart Failure V: Medical Management
26
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
26


